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Biomedical subjects

K Hioki

Publications and source records attributed to K Hioki.

At least 163 records · Page 9Linked to original sources

Quantitative analysis of nodal involvement with respect to survival rate after curative gastrectomy for carcinoma.

We investigated whether or not the survival rate after curative gastrectomy was related to the total number of lymph nodal metastases and the frequency of the metastases (number of nodes with metastases among number of dissected nodes) in 433 patients with carcinoma of the stomach. Of these patients, 45.3 per cent had lymph nodal metastases, and of a total of 10,130 dissected lymph nodes, 13.0 per cent had metastases. The present findings suggest that both the number and frequency of lymph nodal metastases are closely related to other prognostic factors, such as depth of invasion, histologic type, gross findings, histologic staging and vascular invasion. The five year survival rate significantly decreased as the number and frequency of metastases increased. Thus, it appears the number and frequency of involved lymph nodes are parameters of prognostic significance.

Gastrectomy↗

Structural and functional alterations in the gut of parenterally or enterally fed rats.

Various regimens of total parenteral nutrition (TPN) and enteral feeding were compared to determine their effects on the structural and functional changes of rat small intestine. Male Wistar rats, allocated randomly into five groups on the basis of delivery route and composition of nutrients, were fed as follows: standard rat chow ad libitum (CE-2 group), low-residue diet (LRD group), LRD supplemented with 1% (w/v) fiber (LRD + fiber group), elemental diet (ED group), and TPN (TPN group). At 2 weeks of feeding, villi in the terminal ileum decreased in height in the following order: CE-2 group greater than LRD + fiber group greater than LRD group greater than ED group greater than TPN group. Mucosal diamine oxidase activity remained unchanged in the CE-2 group and LRD + fiber group throughout the experimental period. However, mucosal diamine oxidase values were significantly lower in the remaining three groups, similar to the structural changes, and those values in the ED group were significantly decreased at 2, 3, and 4 weeks. There was a positive correlation between plasma diamine oxidase level and mucosal diamine oxidase content, with a coefficient correlation of y = 0.20x + 0.03, r = 0.55 (P less than 0.01). These results could be interpreted to indicate that addition of dietary fiber to LRD has a favorable effect on the maintenance of intestinal architecture and function during enteral feeding, and plasma diamine oxidase activity can be used as an index of functional and/or structural changes occurring in the small intestine during enteral or parenteral feedings.

Amine Oxidase (Copper-Containing)↗

Strategy for lymphadenectomy of gastric cancer.

To determine the extent of lymphadenectomy necessary to cure early gastric cancer, the relationship between the frequency of nodal involvements and the extent of the primary invasion was examined in 274 patients with primary cancer of the stomach. We also evaluated the relationship between the number of metastatic lymph nodes, the pattern of metastases to the nodes, and the histologic type of the primary tumor. In early gastric cancer, lymph node metastasis was more frequent in protruded-type cancer with invasion into the submucosa more than 3 cm in diameter and located in the lower third of the stomach, but was limited to the group 1 lymph nodes, which were defined as being anatomically located nearest to the cancer. In cancer invading into the muscularis propria, metastasis to the group 2 or 3 lymph nodes, which were defined as being anatomically located farther from the cancer than group 1, was found. The number of lymph nodes involved and extent of cancer metastasis in these lymph nodes metastasis, differentiated early gastric cancer had more lymph node involvement and wider extent of metastases than undifferentiated cancers. The cancer cells sometimes replaced most of the node and invaded the perinodal fatty tissue, even in early gastric cancer. In addition, it is occasionally difficult to distinguish macroscopically early gastric cancer with submucosal invasion from cancer invaded into the muscle layer. In conclusion, group 1 and 2 lymph nodes, including perinodal fatty tissue, should be removed completely, even in early gastric cancer, except for carcinoma in situ, particularly when the cancer is of the differentiated type.

Adenocarcinoma↗

Effect of dietary eicosapentaenoic acid on azoxymethane-induced colon carcinogenesis in rats.

The effects of eicosapentaenoic acid (EPA, n-3 polyunsaturated fatty acid) and linoleic acid (n-6 polyunsaturated fatty acid) on azoxymethane-induced colon carcinogenesis in rats were studied. Male Donryu rats were given two types of semipurified diet containing 4.7% EPA plus 0.3% linoleic acid and 5% linoleic acid. The rats were given s.c. injection of azoxymethane (7.4 mg/kg body weight once a week for 11 weeks) and sacrificed 15 weeks after the last injection of azoxymethane. The tumor incidence and tumor yields (tumors per rat) of the colon were significantly lower in rats on the EPA diet compared to those on the linoleic acid diet; i.e., 33%, 0.41 +/- 0.61 and 69%, 1.66 +/- 1.69, respectively. In the analysis of phospholipid fatty acid composition, the colon tumor showed higher levels of arachidonic acid and lower levels of linoleic acid than those in the normal colon mucosa in both diet groups. Despite the increase of arachidonic acid in colon tumor, the EPA diet suppressed the excessive production of prostaglandin E2, which may be accompanied with neoplastic formation, whereas linoleic acid diet caused a marked increase in the tumor content of prostaglandin E2 compared to normal colon mucosa. These results suggest that EPA exerts its inhibitory effect on colon carcinogenesis by modulating lipid metabolism and inhibiting prostaglandin E2 synthesis in tumor cells.

Animals↗

Pulmonary complications after subtotal oesophagectomy.

The postoperative pulmonary complications in 25 patients undergoing subtotal oesophagectomy for intrathoracic oesophageal carcinoma during the 3-year period 1981-1983 were compared with those of 25 patients undergoing surgery from 1984 to 1986. Although more extensive lymphadenectomies were performed from 1984, the mortality rate caused by the postoperative pulmonary complications was zero in the later period (1984-1986) compared with a rate of 16 per cent in the earlier period (1981-1983). The incidence of postoperative pulmonary complications was lower in the later series but the difference was not statistically significant. Factors which may have contributed to the decrease in critical pulmonary complications after surgery during the later period were the selection of the posterior mediastinal route for reconstruction, the introduction of selective endobronchial intubation by a double lumen tube with combined epidural anaesthesia, fluid restriction during and after surgery, postoperative mobilization and the administration of an expectorant.

Aged↗

Risk factors in relation to postoperative complications in patients undergoing esophagectomy or gastrectomy for cancer.

To clarify the risk factors contributing to postoperative complications in the elderly patients (over 70 years) undergoing esophagectomy and/or gastrectomy, 364 patients with primary cancer seen were evaluated. As a result, some characteristic patterns of stress response in the elderly could be detected as follows: the disorders of the vital organs were more important indices for the development of postoperative complications rather than age, and a reduction in the maximum response of the stress hormones to surgical procedures in aged patients was noted; moreover, the functional variability of target organ in the aged group was confirmed. Studies on the hormonal response to surgery suggest that the restriction of fluid replacement is advisable until the third postoperative day, maintaining the host on the dry side, to prevent cardiopulmonary complications. As the nutritional status in the patients with esophageal and gastric cancer goes from bad to worse with the advancing clinical stages, adequate perioperative nutrition is imperative to prevent complications such as anastomotic leakage, wound dehiscence, and/or infections. For the treatment of anastomotic leaks after esophagectomy and esophagogastrectomy, more than 45 kcal/kg/d must be provided, and the serum albumin level must be restored to 3.5 g/dL in order to achieve spontaneous healing of small anastomotic leakages.

Adult↗

[A case report of brain metastasis due to an advanced gastric cancer].

In April 1984, a 49-year-old male underwent a partial gastrectomy for advanced gastric cancer. At that time, many metastatic foci were found, for example, in the rib, the lumbar vertebrae, the cervical vertebrae, and in the abdominal lymph nodes. Approximately one year later, he suddenly became disturbed and lost consciousness. A metastatic brain tumor was diagnosed. To destroy this tumor the patient received a course of irradiation therapy with a total dose of 45 gys directed toward head. Several months later, however, recurrence of the tumor was detected at the same intracranial region. Thus, a course of therapy, employing a combination of FT-207 and ACNU, was initiated against the recurrent tumor. Though the tumor was not eliminated, the patient manifested few of the prior symptoms. This state has continued for several months, with the patient having survived for three years after his gastrectomy. The following report will present the details of this case.

Brain Neoplasms↗

[Reduced operation for rectal cancer].

The effectiveness of extended dissection of higher-ranked lymph nodes in patients with rectal cancer has been well recognized recently. However, to prevent postoperative bladder and sexual dysfunction, reduced lymphadenectomy and autonomic nerve preservation are necessary. By definition a reduced operation for rectal cancer attempts to preserve the autonomic nerve and the levator ani muscles without hampering recovery. To clarify the indication of reduced operation for rectal cancer, 219 patients with rectal cancer who underwent resections at our hospital between 1980 and 1986 were analyzed. The relationship of the depth of tumor invasion through the bowel wall to lymph node metastasis in rectal cancer was examined. In cases of rectal cancer limited to submucosa or muscularis propria, the degree of metastatic spread was n0 or n1 (+). In the cases of rectal cancer invading subserosa, serosa or contiguous structures, the degree of metastatic spread was n3(+) or n4(+). Concerning the relationship of the histopathological type and 5-year survival rate, the corrected 5-year survival rate was 72.46% in cases of well and moderately differentiated adenocarcinoma, and 48.84% in cases of poorly differentiated adenocarcinoma and undifferentiated carcinoma. From these results, reduced lymph node dissection and autonomic nerve preservation are possible in patients with well and moderately differentiated adenocarcinoma with invasion into the mucosa, submucosa and muscularis propria.

Humans↗

Correlation of T cell receptor gene rearrangements to T cell surface antigen expression and to serum immunoglobulin level in scid mice.

The severe combined immunodeficient (scid) mouse which has undetectable serum immunoglobulin (Ig) contains a small number of thymic lymphocytes which express Thy-1 and IL2 receptors (IL2R) but not Lyt-2 or L3T4 molecules. These thymocytes did not show any rearrangement of T cell receptor (TCR) beta-chain genes. Such thymocyte characteristics in the scid mouse were similar to the 15-day embryonic thymocytes in ordinary mice, indicating that the scid mouse thymocytes are arrested in the early stage of intrathymic differentiation. However, low or medium level serum Ig was occasionally found in the littermates of the scid mouse. The thymocytes of these mice showed some evidence of TCR beta-chain gene rearrangement and the presence of Lyt-2+/L3T4+ cells in correlation with the serum Ig level. In the mice with some serum Ig the thymocyte cell number was increased and the proportion of IL2R+ cells was decreased. Collectively, these results suggest that the rearrangement of TCR beta-chain genes is associated with the expression of Lyt-2 and L3T4 molecules in intrathymic differentiation and probably with cell proliferation of the migrated lymphoid cells in the scid mouse.

Animals↗

Studies on beige-nude mice with low natural killer cell activity. 1. Introduction of the bg gene into nude mice and the characteristics of beige-nude mice.

To improve the take-rate of human tumours in nude mice, a nude mouse strain with the bg gene was established. The introduction of the bg gene was confirmed by examination of giant granules of blood neutrophils. The genetic profile of beige-nude mice was the same as that of the C57BL/6 strain according to genetic screening. The natural killer cell activity in the beige-nude mice was much lower than that in ordinary nude mice but slightly higher than that in beige mice. The reproductivity of beige-nude mice was as high as that of ordinary nude mice.

Animals↗

[A case report of triple cancer (lung, stomach & liver cancer)--with special reference to operable cases reported in the literature].

A case of a triple cancer in the lung, stomach, and liver has been experienced and a subsequent operation was performed. It has been noted that the occurrence of triple cancers have increased by about four times during the last decade, no doubt due to progress in more accurate diagnoses and from therapeutic effects. However, operations involving triple cancer still are rare and such cases in the literatures are discussed.

Adenocarcinoma↗

A new mouse model of genetically transmitted polycystic kidney disease.

The clinical and pathologic characteristics of the murine polycystic kidney were examined in a mutant cy/cy mouse found in the KK strain, which is known to be a diabetic strain. This cy/cy mutant appeared to resemble human adult polycystic kidney disease in clinical course and morphology although inheritance was an autosomal recessive trait. Histologic studies of early postnatal animals suggested that cystic alterations might occur in any part of a collecting tubule or nephron. The cy/cy mutant might be a useful model animal for further investigation of early morphologic alterations and progression of cystic disease.

Animals↗

[AFP-producing gastric cancer--analyses of 17 cases].

Serum AFP levels were increased in 17 of 446 patients with primary gastric cancer, No liver metastasis was detected in 11 of them. In all patients who underwent gastrectomy, the post-operative AFP levels were significantly lowered. In patients with recurrence, the increase of AFP levels was detected before the diagnosis of recurrent tumor could be achieved by US or CT. The tumor invasion in most of these patients was graded as ss. Lymph node metastasis was found in all patients. Most tumors were histologically classified as tub 2. The histochemical demonstration of AFP in carcinoma cells of the stomach and metastatic lesions of the liver suggests tht AFP may be produced within cancer cells. The prognosis was generally poor.

Adult↗

Inhibitory effect of dietary selenium on carcinogenesis in rat glandular stomach induced by N-methyl-N'-nitro-N-nitrosoguanidine.

The influence of dietary selenium on the incidence of stomach carcinoma induced by N-methyl-N'-nitro-N-nitrosoguanidine was studied in 108 rats that survived for over 10 wk. The incidence of glandular stomach cancer in the high-selenium (4.0 ppm) diet group (20 carcinomas in 54 rats) was lower than in the low-selenium (0.1 ppm) diet group (33 carcinomas in 54 rats). The selenium level and glutathione peroxidase activity in the blood, liver, and stomach mucosa were significantly higher in the high-selenium diet group than in the low-selenium diet group. Glutathione peroxidase activity as well as the concentration of selenium in the glandular stomach was increased significantly in the high-selenium diet group.

Adenocarcinoma↗

Effects of dietary saturated and unsaturated fatty acids on fecal bile acids and colon carcinogenesis induced by azoxymethane in rats.

To determine whether the kind of dietary fat affects colon carcinogenesis, male Donryu rats were fed a 5% fat diet containing linoleate, an unsaturated fat, or stearate, a saturated fat, in semipurified fat-free chow. The rats were given azoxymethane (7.4 mg/kg body weight) s.c. once a week for 11 weeks and killed 15 weeks after the last injection of the carcinogen. The rats on the unsaturated fat diet had a significantly higher incidence of colon tumors. Fatty acid analysis of cholesterol esters in the liver and examination of the amount of fecal bile acids showed that the unsaturated fat diet increased the level of cholesterol linoleate and arachidonate in the liver and also increased the fecal excretion of bile acids, especially that of lithocholic acid. The colon tumors in rats on the unsaturated fat diet, compared with those in rats on the saturated fat diet, contained a higher level of lysophosphatidylcholine. These results suggest that increased fecal excretion of bile acids due to increased polyunsaturated cholesterol esters in the liver stimulates phospholipase A2 activity of colon initiated cells and enhances colon carcinogenesis in rats on the unsaturated fat diet.

Animals↗